eddienomura’s AchillesBlog

Day Before Surgery
June 2, 2014, 2:49 pm
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I ruptured my left achilles on May 20th and delayed my surgery until tomorrow due to traveling. My calf has been sore the last few days, taking Ibuprofen has worked so far.

Welcome! Probably too late to start madly reviewing the latest evidence on op vs. non-op, eh? But at least make sure that your OS is planning to move you along as fast as the non-op patients go, as outlined at achillesblog.com/cecilia/protocols . (It’s ironic that many surgical ATR patients are still told that they’ll go faster if they choose surgery, but then they actually go slower than the new non-op protocols!)

Many of us have been told that NSAIDs in general (including ibu/Advil) are bad for healing tendons including ATRs. I’ve never tried to get to the bottom of the evidence, but many OSs and pros and websites say it’s so, so it may well be. I’ve never heard that about acetaminophen (Tylenol in many places).

Comment by normofthenorth 06.02.14 @ 3:40 pm

Reviewed the protocols, thank you. Returning my AT close to original strength was the selling point for me. I have a physically demanding job, am a runner, swimmer. Prior to my injury I averaged 50 miles per week and I swam, surf, etc. Good for Kobe Bryant good for me? Thanks for the NSAID info!

Comment by eddienomura 06.02.14 @ 4:06 pm

Hard to believe that Kobe is much stronger than the YouTube videos of Brady Browne! But you’re quite right that most pro athletes are still opting for the op. (And one study I’ve seen on US football players says they mostly don’t quite return to their previous top form.)

Wallace says he got 100% return to sport with 945 non-op patients, using a simple “trick” to make sure the torn ends are adjacent (approximated) at the chosen immobilization angle. I’m not sure most surgical studies achieve 100% return to sport.

The UWO study (full text on this site) does show a pretty consistent below-the-radar (not statistically significant) strength difference in favor of the post-op cohort.

Interesting times, good luck, keep posting, be happy with your choice, both ways seem to get remarkably good results, including many patients who feel 100% or even measure 100% — eventually, of course!

And if you want to take the time to find the substance behind the NSAIDs-are-bad-for-tendons claims, you could enlighten us all!

Comment by normofthenorth 06.02.14 @ 4:20 pm

Good luck tomorrow - I hope all goes well! If you opt for a nerve block, be careful to stay ahead of the pain, as it takes about 24 hours to wear off, during which time I was lulled into thinking it was not going to hurt at all post-surgery. When the block wore off, I was caught off guard. Luckily, things do get better pretty quickly!

Comment by jeffk58 06.02.14 @ 6:27 pm